Estimation of life-time survival and predictors of mortality among the people living with HIV/AIDS: a case study in Andhra Pradesh, Indi

Ram C. Bajpai; Himanshu K. Chaturvedi; Sarvesh Kumar; Arvind Pandey

doi:10.18203/2394-6040.ijcmph20160914

Authors

Ram C. Bajpai Nayati Healthcare, Gurgon, Delhi
Himanshu K. Chaturvedi National Institute of Medical Statistics, New Delhi
Sarvesh Kumar Department of Community Medicine, RUHS, College of Medical Sciences, Jaipur, Rajasthan
Arvind Pandey National Institute of Medical Statistics, New Delhi

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20160914

Keywords:

HIV/AIDS, ART, Survival, Kaplan-Meier, Andhra Pradesh, India

Abstract

Background: Antiretroviral treatment (ART) consistently improved survival of people living with HIV and contributes to prevent new infections. In this study, we estimated the life-time survival and examined the associated correlates of mortality amongst HIV-patients registered during 2007-11 in Andhra Pradesh, India.

Methods:A total 63,882 adult HIV/AIDS cases (≥15 years) with complete follow-up information were extracted from ART database and included in the analysis. The Kaplan-Meier method was used to estimate the survival and Cox PH model was used to determine the relative hazard of mortality.

Results: Nearly twelve percent (11.9%) of the total cases them (n=7,621) died during the follow-up period. Overall life-time survival was estimated to 12.2 (95% C.I. 12.0-12.3) years. Multivariable Cox proportional hazard model indicated the mortality was significantly associated with age, CD4 count, gender, clinical stage and functional status.

Conclusions:The scale-up of ART has resulted in substantial reductions in mortality and increased survival. Such information is useful for institution of intervention measures to reduce risk of death.

Metrics

Metrics Loading ...

References

World AIDS Day Report. UNAIDS, Geneva, Switzerland, 2012.

Technical reports: India HIV estimates. National AIDS Control Organization. Ministry of Health & Family Welfare, India, 2010.

Pandey A, Sahu D, Bakkali T, Reddy DCS, Venkatesh S, Kant S, et al. Estimate of HIV prevalence and number of people living with HIV in India 2008–2009. BMJ Open. 2012;2:e000926.

Egger M, May M, Chene G, Phillips AN, Ledergerber B, and Dabis Fet al. Prognosis of HIV-I infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. Lancet. 2002;360:119-29.

Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P et al. Changing patterns of mortality across European patients infected with HIV-I, EuroSIDA Study Group.Lancet. 1998;352:1725-30.

Kim JY, Ammann A. Is the ‘‘3 by 5’’ initiative the best approach to tackling the HIV pandemic? PLoS Med. 2004;1:e37.

Bachani D, Garg R, Rewari BB, Hegg L, Rajasekaran S, Deshpande A, et al. Two-year treatment outcomes of patients enrolled in India’s national first-line antiretroviral therapy programme. Natl Med J India, 2010;23:7-12.

Annual reports: 2011-12. National AIDS Control Organization, Ministry of Health & Family Welfare, India.

Vella S, Schwartlander B, Sow SP, Eholie SP, Murphy RL. The history of antiretroviral therapy and of its implementation in resource-limited areas of the world. AIDS. 2012;26:1231-41.

Kee MK, Lee JH, Kim EJ, Lee J, Nam JG, Yoo BH et al. Improvement in survival among HIV-infected individuals in the Republic of Korea: Need for an early HIV diagnosis. BMC Infectious Diseases. 2009; 9:128.

Bajpai RC, Raj PY, Jha UM, Chaturvedi HK, Pandey A. Demographic Correlates of Survival in Adult HIV Patients Registered at ART Centers in Andhra Pradesh, India: A Retrospective Cohort Study. PHR. 2014;4:31-8.

WenchekoE AT. Survival analysis of patients under chronic HIV-care and antiretroviral treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Ethiop J Health Dev. 2012;26:22-9.

Shaboltas AV, Toussova OV, Hoffman IF et al. HIV prevalence, sociodemographic, and behavioral correlates and recruitment methods among injection drug users in St. Petersburg, Russian. J Acquir Immune Defic Syndr. 2006;41:5.

Ghate M, Deshpande S, Tripathi S, Godbole S, Nene M, Thakar M et al. Mortality in HIV infected individuals in Pune, India. IJMR. 2011;133:414-20.

District Level Household and Facility Survey (DLHS-3), 2007–08: India: Key Indicators: States and Districts, IIPS, Mumbai, India.

Teja VD, Sudha T, Lakshmi V. Causes and pattern of mortality in HIV infected, hospitalized patients in a tertiary care hospital: a fourteen year study. Indian J Med Sci. 2007;61:555-61.

Mermin J, Were W, Ekwaru JP, Moore D, Downing R, Behumbiize P, et al. Mortality in HIV-infected Ugandan adults receiving antiretroviral treatment and survival of their HIV-uninfected children: a prospective cohort study. Lancet. 2008;371:752-59.

Hambisa MT, Ali A, Dessie Y. Determinants of mortality among HIV positives after initiating antiretroviral therapy in Western Ethiopia: a hospital-based retrospective cohort study. ISRN AIDS. 2013;1-7.

Doherty MC, Garfein RS, Monterroso E, Brown D, and Vlahov D. Correlates of HIV infection among young adult shortterm injection drug users. AIDS 2000;717-26.

Alonso-Gonzalez M, Martin L, Munoz S, Jacobson J. Patterns, trends and sex differences in HIV/AIDS reported mortality in Latin American countries: 1996–2007. BMC Public Health. 2011;11:605.

Arrivillaga M, Ross M, Useche B, Alzate ML, Correa D. Social position, gender role, and treatment adherence among Colombian women living with HIV/AIDS: social determinants of health approach. Revista Panamaricana de Salud Publica. 2009;26:502-10.

Mallitt KA, Grigoryan SR, Papoyan AS, Wand HC, Wilson DP. Access to antiretroviral therapy and survival in eastern Europe and central Asia: a case study in Armenia. J Int AIDS Soc. 2014;17:18795.

Hambisa MT, Ali A, and Dessie Y. Determinants of mortality among HIV positives after initiating antiretroviral therapy in Western Ethiopia: a hospital-based retrospective cohort study. ISRN AIDS 2013;1-7.

Dominique YMG. HIV/AIDS in Haiti: an analysis of demographics, lifestyle, STD awareness, HIV knowledge and perception that influence HIV infection among Haitians. Public Health Theses. 2011:172.

Doherty MC, Garfein RS, Monterroso E, Brown D, Vlahov D. Correlates of HIV infection among young adult shortterm injection drug users. AIDS. 2000;717-26.

Taylor-Smith K, Tweya H, Harries A, Schoutene E, and Jahn A. Gender differences in retention and survival on antiretroviral therapy of HIV-1 infected adults in Malawi. Malawi Med J. 2010;22:49-56.